SR 24-03 Dated 12/23 |
STATE OF NEW HAMPSHIRE
DEPARTMENT OF HEALTH & HUMAN SERVICES - Bureau of family assistance (bfa)
INTER-DEPARTMENT COMMUNICATION
FROM THE OFFICE OF: |
Director of Division of Economic Stability (DES), Karen Hebert |
BFA SIGNATURE DATE: |
December 26, 2023 |
FROM THE OFFICE OF: |
Director of Division of Medicaid Services (DMS), Henry Lipman |
DMS SIGNATURE DATE: |
December 23, 2023 |
AT (OFFICE): |
Bureau of Family Assistance Division of Medicaid Services |
TO: |
All BFA Staff All DMS Staff All BES Staff |
SUBJECT: |
System of Care Changes |
EFFECTIVE DATE: |
January 1, 2024 |
SUMMARY
This Supervisory Release (SR) releases changes to the System of Care requirements.
FORMER POLICY |
NEW POLICY |
A resource assessment is completed to determine what amount of a spouse’s resources count towards the institutionalized spouse in a nursing home or applying/receives home and community-bases 1915(c) services and what resources are protected for the community spouse. |
A resource assessment is completed to determine what amount of a spouse’s resources count towards the institutionalized spouse in a nursing home and what resources are protected for the community spouse. A resource assessment is no longer a condition of eligibility in determining eligibility for home and community-based 1915(c) services. |
Individuals seeking nursing facility and home and community-based 1915(c) waiver services (HCBS) shall not have a resource disregard. |
For individuals seeking nursing facility and home and community-based 1915(c) waiver services, a resource disregard shall be applied so that the effective resource limit is $7,500. |
The look-back period for all asset transfers is 60 months. |
The look-back period for all asset transfers is up to 60 months. |
BACKGROUND
House Bill (HB) 2, Chapter 79, Laws of 2023, authorized the department to eliminate the spousal impoverishment requirements, increase a resource disregard for all individuals eligible for medical assistance under Home and Community-Based Services Choices for Independence (HCBS-CFI), Home and Community-Based Services for the Developmentally Disabled (HCBS-DD), and Home and Community-Based Services for Individuals with an Acquired Brain Disorder (HCBS-ABD), and use a minimum lookback period of 36 months up to a maximum 60 months.
POLICY
Resource Assessment
Individuals eligible for medical assistance for Home and Community-Based Services Choices for Independence (HCBS-CFI), Home and Community-Based Services for the Developmentally Disabled (HCBS-DD), and Home and Community-Based Services for Individuals with an Acquired Brain Disorder (HCBS-ABD), will no longer be subject to the resource assessment (spousal impoverishment) requirements.
Resource Disregard
A resource disregard for individuals applying for and receiving nursing facility medical assistance or a HCBS waiver shall be applied so that the effective resource limit is $7,500. Examples of disregards shall be applied as follows:
· Categorically Needy for household size of 1 is $6,000 deduction amount.
· Medically Needy for a household size of 1 has a $5,000 deduction amount.
· Medically Needy for a household size of 2 or more:
Lookback Period
The determination of whether a 36 or 60-month lookback period is required, and an AVS report is run or resources are manually requested based on information provided by the applicant on their application. The following tiers describe the various lookback periods requests as determined by DHHS:
Tier 1: 1-month lookback period. Applicants who have been receiving assistance with DHHS for 3 or more years. Since these applicants have had assets previously verified, they only need to provide current information.
Tier 2: 36- month lookback period. Applicants who are not in Tier 1 or Tier 3 only a 36-month lookback period is required and an AVS report will be run. If nothing found in 36 month, do not need to check 37-60 months.
Note: If an applicant has real property, it will impact whether they are tier 2 or 3. Will transition real property search to pre-interview from post-interview. If search shows transfer of real property, then 60-month AVS. If applicant has RE, but it was not transferred a 36-month AVS report for 36 months will be requested.
Tier 3: 60-month lookback period. Applicants that have (i) an annuity and/or a funded trust, an IRA/other retirement account; or (ii) transferred real property, a 60-month lookback period is required and an AVS report for 60 months is obtained and reviewed.
· In some cases, an applicant may have other valuable assets. For example, a time share, life estate, boat, RV, etc. If these assets were transferred within 60-months of application, the Family Services Specialist will review transfer.
· When a NF or HCBS application is received with the appropriate identification information, the Family Services Associate will initiate an Accurint check to determine if real property exist.
· If Accurint or other questionable resources are unable to be verified prior to interview, lookback period will default to 60 months.
NEW HEIGHTS & NH EASY SYSTEMS PROCEDURES
New HEIGHTS changes will be effective January 1, 2024.
· A new resource disregard will be seen on the Resources Results screen in the NF/HCBC Deduction field.
· The Manual Request screen has be modified to allow workers to select 36 months in the Asset Verification Request field.
POLICY MANUAL REVISIONS
Medical Assistance Manual (updated as of February 1, 2024)
Section 407.01 Categorically Needy Medical Assistance
Section 407.03 Medically Needy Medical Assistance
Section 415.03 Look-back period for Transfers of Assets
Section 415.05 Transfers by Financial Assistance Applicants or Recipients
Section 415.07 Transfers by and Institutionalized Individual
Section 415.09 Transfers by the Community Spouse of an Institutionalized Individual
IMPLEMENTATION
This policy is effective January 01, 2024
CLIENT NOTIFICATION
The following notice letters were updated as part of the System of Care changes:
· AE0015, Resources Available to Institutionalized Individuals at Application v1
· AE0026, Verification Checklist v1
· AA0114, Notice of Decision Medicaid LTC
· CS0025, LTC Initial Intake Letter
· CS1025, LTC Initial Intake Letter for RFA
TRAINING
No special training is planned or needed.
DISPOSITION
This SR may be destroyed or deleted after its contents have been noted and the revised manual topics released by this SR have been posted to the Online Manuals.
DISTRIBUTION
This SR will be distributed according to the electronic distribution list for BFA policy releases. This SR, and revised Online Manuals, will be available for agency staff in the Online Manual Library, and for public access on the Internet at https://www.dhhs.nh.gov/sr_htm/sr.htm, effective January 1, 2024.
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